To the CNAs and other nursing staff “working” at a nuring home located in a small town in southern Illinois…

“FCOL!!! U been seen txting while on the clock (at and/or near the nurse’s station). U are pd. to care for yur residents, not play w/yur cell phones while on the job. Pls work on being more responsive 2 the residents entrusted to yur care! U certainly wouldn’t want the state inspectors 2 find U txting while at work, would U? Does yur facility need a surprise inspection to get this problem fixed? When a resident has GGP, s/he shouldn’t have 2 wait on you BC U R playing w/your phone! Yur facility has a great reputation, too bad your job performance doesn’t prove 2 b so hot! Now then: get B2W!”

Here’s a translation of the above text message…

“For crying out loud!!! You’ve been seen sending and receiving text messages while on the clock (at and/or near the nurse’s station). You are being paid to care for yur residents, not play with your cell phones while on the job. Please work on being more responsive to the residents entrusted to your care! You certainly wouldn’t want the state inspectors to find you playing with your cell phone while at work, would you? Does yur facility need a surprise inspection to get this problem fixed? When a resident has to got to go pee, s/he shouldn’t have to wait on you because you’re playing w/your phone! Yur facility has a great reputation, too bad your job performance doesn’t prove to be so hot! Now then: get back to work!”

When a nursing home resident needs assistance of any sort, nursing staff should never allow the use of their cell phone, taking excessive smoking breaks or gossiping with co-workers to slow their response time. Please remember that you are paid to CARE for your residents — and to refuse to do so clearly constitutes neglect!

Over the past several weeks I’ve begun to keep a much closer eye on news media coverage of the many aspects of the nursing home industry. Information I’ve discovered points to a disturbing pattern involving massive fraud and deception by numerous players in the industry!

It is abundantly clear that HUNDREDS OF MILLIONS of dollars in government funding given to nursing homes with the expectation that the monies would be used to increase staffing levels and improve other aspects of resident care have instead gone to significantly increase the profit margins of many for-profit nursing home owners. This problem may involve facilities in nearly 30 states (including Kentucky, Indiana and California) and can be traced as far back as 2003, when individual states (thanks to pressure from the wealthy nursing home industry) began offering financial incentives with the intention that the funding would improve the quality of nursing home care. Not surprising to those of us who have had loved ones living in nursing homes over the past decade, the quality of resident care has actually significantly declined!

For-profit nursing homes guilty of fraud and deception involving government money? Say it ain’t so! Then again, over the past few weeks we’ve also uncovered many news reports that tell the tale of entire nursing home corporations — from Georgia to Ohio — being indicted for deceptively over-billing Medicare and other insurance providers.

Yes, friends. Stealing, lying and other forms of deception are all-too-common within the nursing home industry. When it comes to dealing with nursing facilities on a personal level (regarding the care of a loved one) you are wise to be cynical and to closely examine every claim made by the pathological liars that are all-too-present within the nursing home industry!

The following comment was written by a nurse who describes herself as being at the “breaking point” due to the daily stress caused by understaffing in the facility where she’s worked the day shift for approximately three years. We feel the stress this nurse is experiencing and ask you to join us in praying for this person and all compassionate, hard working nurses and nurse’s aides that God will grant them the strength to do all they can for the resident’s entrusted into their care.

The nurse that wrote the following comment works the day shift at a nursing home located in Indiana, which is one of 13 states where the nursing home industry has such an overwhelming control of state legislators that no minimum staffing standards are in place.

I love building a relationship with my nursing home residents. I live for making their day a little better. Yet more and more I feel like I am going to have a breakdown. I don’t think I can do it anymore. The demands made by administrators are unattainable because there are too few people on the floor working.

I work day shift — when management is in the facility — despite being clearly short staffed, they act like its not a big deal. Then they leave and the staffing levels on second and third shift are even worse! IF they failed to staff enough people they will threaten us if we leave with charges of abadonment instead of taking the floor themselves.

I want to take quality care of my residents. I used to think it was my fault and that if I just tried harder and harder all would be well. Now I see more and more its them (management)! I stay over late hours nearly every night. I don’t take lunch breaks but maybe once a week. I feel by staying in this job I’m condoning the poor care. I pray every morning before I go in for God to give me the strength to be the best I can be to provide for my residents.

I have to find a new job. I cant condone this any longer. The facility where I work wasn’t always like this. But then new management took over a few years ago.

This morning I had to wait until 9:00am to pass morning medications because there was no one to feed residents who must have assistance with eating. So I feed them the best I could, but there should have been two additional staff on duty to take care of this important need!

I hate not revealing the WHOLE truth to familys, but the WHOLE truth is too ugly.

Speaking of prayer, we also need to be praying for God to move upon the hearts and minds of all for-profitnursing home owners, administrators and stock holders — these people are responsible for the insanity and inhumanity of understaffing. Their greed has created and intensified the problem in Indiana and elsewhere.

Breakingnurse

E-mail

none@aim.com

Comment

I am day shift nurse in an Indiana LTC faciltiy I have been doing this for the past three years @ the same place. I love building a realtionship with the residents, I live for making their day a little better. And more and more I feel like I am going to have a break down .I dont think I can do it anymore. The demands made by administrators are unattainable becasue there are just too few people on the floor working. I work day shift, and management is there, we will be short on the floor and they act like its not a big deal. Then they leave and 2nd and 3rd shift are staffed even worse. IF they failed to staff enough people they will threaten us if we leave with charges of abadonment instead of taking the floor themselves. I want to take quality care of people, I used to think it was my fault that if I just tried harder and harder and now I see more and more its them! I stay over late hours nearly everynight, I dont take lunch breaks but maybe once a week. I feel like if stay I will be condoning the poor care that is available.I pray every morning before i go in for God to give me the strenght to be the best I can be to provide for my residents. I have to find a new job, I cant condone this. The facilty wasnt always like this, then we got new management a few years ago. This morning I had to wait until 9am to pass am meds because there was no one to feed people in assistive eating, so i feed them the best I could but there should have been 2 people. I hate not revealing the WHOLE truth to familys, but the WHOLE truth is too ugly and I now there isnt a better long term care facilty.

I’ve had some recent discussions with three individuals (two different families) who have loved ones residing at a nursing home located near Indianapolis. To clarify: all three individuals have loved ones residing in the same facility.

To give you an idea of just how dysfunctional this particular nursing home is, consider that 16 (yes, sixteen) administrators have come and gone in just under 10 years! Nothing like “stability”, huh?

One of three family members I spoke to reports that when visiting the facility at 8:30pm on a recent weeknight, three nursing staff members were serving the unit where their loved one resided. Despite three staff members being on duty, their loved one’s call light wasn’t responded to in a timely manner. It took the family member physically going to the nurse’s station to get a response to the call light! What was the hold up causing the delay in response? The staff members acted as if they had nothing to do but sit around and engaging in chit-chat with each other!

Another family member, who’s loved one is dependent on an oxygen tank, discovered the device’s filter had about 1/4 inch of dust, meaning that it hadn’t been cleaned in quite a while.

In the same nursing home, the refrigerator (which is the nursing home’s property) in another resident’s room had mold growing in it! The appliance was replaced, but only after more than one week had passed after the first complaint was made. Mold, dust and dirt on the floor of the showers in the same facility was also a common site. One room with a dirty shower had not been cleaned for over two weeks, despite repeated complaints.

The nursing home mentioned above is a for-profit facility and part of a large corporation that owns several nursing home in the United States and Canada. This facility in central Indiana is ranked in the lower one-third when compared to the other nursing homes in Indiana.

We find it rather ironic that the corporation who owns the nursing home in question has the word “Care” in their name! Non-responsive staff, the presence mold another other filth (on oxygen tank filters, in resident rooms — including their showers) is anything but a sign of real “care” for residents of this facility. As one friend pointed out to me a few years ago, to use the word “care” and the phrase “for-profit” in the same sentence is a contradiction!

Regarding this nursing home near Indianapolis, once again we must ask: Where is the money going? The room that had a mold growing in the refrigerator is located on the “rehabilitation unit” of this facility. The room rate for this unit is around $700 per day!

When it comes to non-responsive/slow-to-respond nursing staff members, our observation is this is typically a problem at night, on weekends and holidays and any other time when management is not in the building. Obviously, we don’t expect management to work “24/7”, but in large facilities that have an Assistant Administrator (in addition to the main Administrator), why not schedule them for different shifts?

Nursing home administrators could also show up unexpectedly a few hours before the start of their regular shift — on a random day, once or twice per month. Could they not also occasionally work a different shift than they normally work?

Even in a smaller facility where it isn’t cost effective to have an Assistance Administrator, the Director of Nursing (which every nursing is required to have on staff) could be scheduled for different hours other than those worked by the administrator.

Keep in mind that the average annual salary of nursing home administrators is around $75,000. While the average salary of a Director of Nursing is over $60,000. So why not hold these individuals accountable to hold their staff more accountable for their actions?

My own experiences while advocating for my mother’s health care when she lived at an unbelievably awful nursing home in Jeffersonville, Indiana, not to mention nurerous messages I’ve received from visitors to this website and the verbal accounts shared by nursing home reform advocates lead me to strongly believe that many nursing home owners, administrators and management personnel are major league control freaks! Despite our constitutional right to Freedom of Speech, many of these nut jobs will do whatever they can to bluff and manipulate nursing home residents and their family members into keeping silent about the neglect and abuse suffered by many nursing home residents.

I’ve even had two nursing home administrators contact me through this blog within the past month to attempt to pressure me into “softening” my criticism of the nursing home industry. Please: Don’t waste your time! I will NOT be silent and I WILL continue to expose the truth about the hideously inapporpriate nature of nuring home care in the United States. Nursing home insiders may think they have the right to silence their critics, but they don’t!

If a nursing home owner, administrator or other management person has attempted to silence you, I want to know about it! If they’ve tried to prevent you from visiting your loved one inside a nursing home (in clear violation of the resident’s civil rights), please share this information with me! If you’ve been fired in retaliation for reporting to the state, discussing with a family member or nursing home management regarding problems within a nursing home setting, then please allow me to share your nightmare with the readers of this blog!

The tactics some nursing home officials use to control others are not only emotionally toxic, they are often illegal. I believe that shining the light of truth on this frighening aspect of the nursing home industry is one way to bring about change. If they deep down believed that they were in the right, then why would these people attempt to silence their critics? They know the nursing home industry has some major problems and the word is and will eventually get out about the seriousness of these problems, regardless of what the control freaks attempt to do!

The Indianapolis Star (http://www.indystar.com) has published a second scathing investigative report about the serious problems in nursing homes throughout the Hoosier state. This newest well-documented article focuses on the mis-use of government money that was supposed to go into improving nursing home care — but instead ended up being used to line the pockets of the big for-profit nursing home chains.

In this most recent news article, the following tale was related about a Kindred Healthcare owned and operated facility in Greenfield, Indiana. This is the kind of thing that the control freaks don’t want you to know, but I’m going to tell you about because you (as a taxpayer) have a RIGHT to know just how dysfunctional and dangerous nursing homes have become — and by mis-spending your tax monies residents are being allowed to slowly starve to death because the greedy people who run the facilities wont hire enough staff to feed the residents…

Just last year (2009), an Indiana Board of Health investigation at Regency Place revealed a blind and toothless resident wasn’t being provided with food appropriate for their medical conditions. In fact, it appears this dear woman wasn’t even being offered assistance with feeding (something a blind person clearly deserves to be offered at every meal!). “Inspectors found the woman trying to eat by dipping her fingers in her glass of milk and then sucking on them” to obtain nourishment!

Nursing home residents, many who suffer with dementia and are thus unable to speak up for their rights, need our voices (yours and mine!) to protect them from corporate greed. Therefore we must NEVER allow the control freaks to silence us. Indeed (to borrow a line from activists who have supported various causes over the years), “Silence = Death”!

A standing ovation should be given to New York (state) Attorney General Andrew Cuomo and his staff for using hidden cameras INSIDE nursing homes in order to catch negligent and abusive caregivers red handed! In a news article posted on April 1, 2010, Cuomo announced that the use of cameras have helped convict 30 (thirty!) employees found to be mistreating nursing home residents.

New York’s Medicaid Fraud Control Unit has convicted one nursing home company, The Buffalo (N.Y.) News recently reported. In another case, a large nursing home chain has agreed to a civil settlement.

“With the consent of family members, we put hidden cameras in nursing homes across the state, watching over the vulnerable who often cannot advocate for themselves,” Cuomo said in a statement on Wednesday, March 31. “My office is strongly committed to using all the tools at our disposal to make sure people are getting the medical treatment and care they deserve.”

Cuomo announced charges against a total of 22 employees who were employed by two nursing homes, one facility located in Troy and the other near Buffalo. Among the hidden camera findings:

Employees allegedly failed to move an immobile patient and take other steps to prevent bedsores.

Two nurses and one aide allegedly failed to provide necessary treatment to an elderly woman and falsified records to cover up, while five additional aides are charged with a misdemeanor for allegedly moving the woman without using a mechanical lift.

Think about this: 22 caregivers at JUST two nursing homes were found to not be trustworthy. New York state has MULTIPLE HUNDREDS of nursing homes, so this news report begs me to wonder aloud how many MORE nursing home caregivers could be guilty of neglect and abuse! Obviously these problem do NOT just exist in New York state, but in the THOUSANDS of nursing homes throughout the United States and in other countries!

So the next time a nursing home administrator or owner (or any nursing home employee) gets bent out of shape because they seem to think you don’t “trust” them, just remember that some nursing home employees are NOT trustworthy! When hidden cameras have now documented criminal behavior by nursing home staff, then obviously some of these nursing home people (including caregivers) are simply NOT trustworthy! So trust your gut when you sense an owner, management person or caregiver isn’t worthy of your trust. Wise are the family members and friends of nursing home residents who are vigilant and keep a close eye on their loved one — let alone who use a hidden “Granny Cam” to monitor the behavior of staff when they aren’t around!

In my experience of being a health care advocate for my late mother, the least trustworthy employees were often (not always, but often) the ones working evenings, overnights and weekends. Why? One night shift nursing staff member said it best, “I prefer to work at night when the bosses aren’t around.” It was reported to me by a CNA-in-training that “Night time Shirley” (as I called her) routinely took seven to eight smoking breaks (off the unit, and outside the building) PER HOUR! Yeah, I’d like working after hours too if I were a smoker and could get away with such criminally negligent behavior.

ACTION: Ask your state’s Attorney General to use hidden cameras inside of nursing home in order to help catch neglect and abuse by staff of the residents entrusted to their care.